NATIONAL Comprehensive HIV
Prevention, Care and Treatment
TOT TRAINING
Overview of the HIV Epidemic
(Global, Sub-Saharan Africa & National)
July 2023
1
Learning objectives
• Describe the magnitude and trends of the HIV epidemic
in Global, Regional and Ethiopia
• Explain the national response against HIV/AIDS
including major policy and strategic directions
• Describe the current status of the Ethiopian ART
program
2
Summary of the Global HIV Epidemic, 2021
• Global prevalence among adults has leveled since 2001
and was 0.7% in 2021
• There were 38.4 million people living with HIV in 2021
(up from 31.7 million in 2010),
– the result of continuing new infections and people
living longer with HIV.
• About one in seven people with HIV (15%) are still
unaware they are infected.
• Significant declines in new infections since mid-1990s
Summary of the Global HIV ….
• There were still about 1.5 million new infections in 2021,
or about 4,000 new infections per day
• Mortality declined, 650,000 people died of AIDS in 2021
– (due in part to antiretroviral treatment (ART) scale-up).
– A 46% decrease from 1.2 million (in 2010) and a 62%
decrease from the peak of 1.7 million in 2004
• Nearly 45% of PLHIV newly infected live in sub-Saharan
Africa
Summary of the Global HIV Epidemic, 2021
Global HIV epidemic – People Living with HIV
In 2021
Globally
38.4 million +21%
People living with HIV relative to 2010
Source: UNAIDS/WHO Report
Summary of the Global HIV Epidemic, 2021
Global HIV epidemic incidence and mortality since 2010
In 2021
Globally
32%
Decline New infections
annually relative to
2010
38.4 million
People living with HIV
47%
Decline Death
annually relative to
2010
Source: UNAIDS/WHO Report
Summary of the Global HIV Epidemic, 2019
Summary of the Global HIV Epidemic, 2021
Summary of the Global HIV Epidemic, 2019
Summary of the Global HIV Epidemic, 2019
HIV Testing and care continuum
global 2021
Summary of the Global HIV Epidemic, 2021
Regional HIV and AIDS statistics and features 2021
Adults and children Adults and children newly Adult and child
living with HIV infected with HIV deaths due to AIDS
20.6 million 670 000 280 000
Eastern and southern Africa [18.9 million–23.0 million] [530 000–900 000] [230 000–360 000]
5.0 million 190 000 140 000
Western and central Africa [4.5 million–5.6 million] [140 000–270 000] [99 000–210 000]
180 000 14 000 5100
Middle East and North Africa [150 000–210 000] [11 000–38 000] [3900–6900]
6.0 million 260 000 140 000
Asia and the Pacific [4.9 million–7.2 million] [190 000–360 000] [99 000–210 000]
2.2 million 110 000 29 000
Latin America [1.5 million–2.8 million] [68 000–150 000] [18 000–42 000]
330 000 14 000 5700
Caribbean [290 000–380 000] [9500–18 000] [4200– 7600]
1.8 million 160 000 44 000
Eastern Europe and central Asia [1.7 million–2.0 million] [130 000–180 000] [36 000–53 000]
Western and central Europe and 2.3 million 63 000 13 000
North America [1.9 million–2.6 million] [51 000–76 000] [9400–16 000]
GLOBAL 38.4 million 1.5 million 650 000
[33.9 million–43.8 million] [1.1 million–2.0 million] [510 000–860 000]
The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information.
Summary of the Global HIV Epidemic, 2021
Summary of the Global HIV Epidemic, 2021
Historical overview of HIV/AIDS Epidemic, Ethiopia 2019
•1984- The first evidence of HIV infection in Ethiopia
•1985- National HIV/AIDS Taskforce was established
•1986- The first two AIDS cases reported to the MoH
•1987- National AIDS Control Program (NACP) at the MOH
•1998- National Policy on HIV/AIDS
•2000- Federal HIV/ AIDS Prevention and Control Office
established
•2003- PEPFAR launched
Historical overview of HIV/AIDS Epidemic,
Ethiopia 2019
• 2003- ART started, patients pay
• 2000- 2004: PMTCT with single doze NVP, AZT
• 2005- Free ART started through PEPFAR
• 2003-2005, 2008, National treatment guideline
• 2013/14- PMTCT option B+, all children, adults CD4<500
• 2017- ART for all, Test and start
• 2023-Paediatric HIV Program Accelerated initiative
National Adult (15-49) HIV prevalence and PLHIV Pop.
• National Adult (15-49) HIV prevalence - 0.91%
(2022)
610,350 PLHIV
Female: 371,497 (61%)
Male: 238,853 (39%)
Children (0-14): 36,812 (6%)
Overview of National HIV epidemiology
• The Ethiopian HIV/AIDS epidemic is characterized as mixed
• with wide regional variations and concentrations in
– urban areas, including some distinct hotspot areas driven by key
and priority populations.
• National adult (15-49) HIV prevalence is 0.91% in 2022 (EPHI
spectrum)
• Prevalence in women constitutes 61% of infections (women
1.0%, men 0.6%).
• PMTCT coverage 85.9% and Final transmission rate-12.04
Overview…..
• In 2022, the national HIV incidence rate in the adult population is
estimated at 0.08%
• An estimated annual death of 11,000 and 8300 new infections, the
majority (67%) of these occurring in the age group below 30 years
• Wide regional variations- Gambella at 3.7%, Addis Ababa at 3.2%
with the lowest in Somali region at 0.2%.
•
• urban prevalence of HIV in Ethiopia surpass significantly those of
rural areas
• HIV prevalence is seven times higher in urban areas than in rural
areas, (2.9%versus 0.4%, respectively). EDHS 2016
Estimated PLHIV number (in thousand) in 2022
National Adult (15-49) HIV prevalence by
Region
New Infection and AIDS Death
8,257 Annual New 11,322 Annual AIDS Death
Infections in 2022 in 2022
Male: 3,185 Male: 5,480
(39%) (48%)
Female: 5,072 Female: 5,842
(61%) (52%)
Children (0-14): Children (0-14):
1,985(24%) 1,483 (14%)
Annual new infections by region in 2020
AIDS death and HIV new infections
to show the epidemic control
Overview of Ethiopia’s Progress Towards HIV Epidemic Control
2022 PLHIV Estimate
(Spectrum)
610,350
New Infections reduced by
59%
from 2010
Deaths reduced by
52%
from 2010
24
National and regional ART
coverage for adult and
children, 2022
95-95-95
27
